3 Flashcards
How is and where is AF most commonly intiated
aberrant electrical impulses most often from pulmonary veins
Rate of contraction in A-Fib is determined by?
AV node refractory period
HR in AF= 90-170 usually
What determines the duration of QRS?
Bundle branch conductivity…thus bundle branch block = widened QRS
Brain injury timeline
1) Red Neuron and neutrophils (24-48 hours)
2) Microglia (3-5 days)
3) Gliosis, cystic space surrounded by astrocytes (2 wks)
Spleen embryologic orgin
Mesoderm of dorsal mesentery
However: blood supply is from splenic artery (foregut)
Segmentation allows for…
Reassortment (BOAR)
Irregular R-R, narrow QRS, absent P-waves
A-fib
Periodontitis (often necrotizing) can be seen in what autosomal recessive disorder
LAD (absence of CD18)
Infection following live vaccine
T-cell mediated immunity deficiencies (SCID and HIV for example)
Wiskott Aldrich
Deficient cytoskeleton
Anesthetics with high tissue solubility are characterized by large arteriovenous concentration gradients and _______ onset of action
slower
Tropocollagen monomers self-assemble into collagen fibril and are cross linked by
lysyl oxidase
Defect in post translation hydroxylation in RER leading to decreased triple helix stability of collagen
Scurvy
what are the two components of advanced directives?
Living will and health care proxy (proxy must follow patients living will)
microhemaggluttination assay-TP and FTA-ABS for T. pallidium remain positive for life. Track therapy with
VDRL and RPR
shallow painful genital ulceration (chancroid) with regional LAD. Medium with hematin (X factor) useful in culture.
Haemophilus Ducreyi
Nucleus in hypothalamus that monitors blood glucose
Ventromedial (VMN)
Hypothalamic tumors in child
gliomas
Nystan (polyene anti-fungal)
ergosterol pores (sim. to ampB)
Acyclovir converted into
Acyclo-GTP inhibits DNA pol
Viral infection in DM1 patient can lead to
DKA
ventricular fibrillation in acute MI setting leading to SCD is due to what?
electrical instability in the ischemic myocardium
Beta blockers in thyrotoxicosis
decrease sympathetics and decrease rate of peripheral conversion of T4–>T3
Taste to ant. 2/3 of tongue
chorda tympani branch of facial nerve
Posterior 1/3 of tongue taste
Glossopharyngeal nerve IX
Posterior area of tongue root and taste buds of the larynx and upper esophagus
Vagus X
Pneumococcal vaccine that induces T-cell-dependent B-cell response (higher affinity antibodies and memory cells)
Conjugated (diphtheria vaccine)
PCV13
PPSV23 for adults= B-cell only…shittier
Cholera vaccine
oral killed vaccine (need multiple inoculations and boosters)
Oral typhoid and BCG
live attenuated vaccines
Recombinant surface protein vaccine
HBV (similar effectiveness as killed)
Inactivated toxin vaccines
Diptheria and tetanus (development of neutralizing antibodies against toxin)
severe hypoplasia of marrow erythroid elements in the setting of normal granulopoiesis (white) and thrombopoiesis
PRCA
Pathogenesis of PRCA
Inhibition of erythropoietic precursors and progenitors by IgG autoantibodies or cytotoxic T lymphocytes
PRCA associations:
Note: ALL patients with PRCA need a chest X-ray
Thymomas (removal can cure) and lymphocytic leukemias Also parvoB19 (destroys proerythroblasts)
Alpha-galactosidase A (FABRY) normally does what?
Breaks down globotriaosycleramine (Gb3); a sphingolipid also known as ceramide trihexose.
Where can Gb3 build up in Fabry accumulate in kidney?
Glomerulus and distal tubule–>proteinuria and polyuria
Accumulation of cerebroside sulfate
Metachromic leukodystrophy (Arylsufatase A deficiency)
Lysosomal storage disease: Progressive demyelination leading to ataxia, peripheral neuropathy, seizures and hypotonia
Metachromic leukodystrophy
Lysosomal storage disease: Optic Atrophy, developmental regression, seizures
Krabbe disease
Anovulation is common when?
First several years of menarche and last few years of meopause
Anaphylaxis in IgA deficient patient who wasn’t wearing there dang medical alert bracelet
IgE antibodies directed against IgA (anti-IgA)
Side effects of Acetazolamide (ex of use: open or closed angle glaucoma; it is decreasing HCO3 and AQH or in kidney blocks NaHCO3 and water reabsorption)
Somnolence, parathesias, alkalized urine…more rare: metabolic acidosis, hyponaturema, dehydration, hypokalemia
Exchange of genes between 2 chromosomes via crossing over with homologous regions (Ex: nonsegment dsDNA viruses)
Recombination
Uptake of naked DNA or in virology–> incorporation into host cell chromosome. Usually not passed on to progeny virions
Transformation
Drain into the middle and superior rectal veins, which communicate with the internal iliac and inferior mesenteric respectively.
Internal hemroids
Drain via inferior rectal vein into the internal pudendal–>internal illiac
external hemorrhoids
